抗性高血压表型中的交感过度激活:已发表研究的元分析
Guido Grassi1, Fosca Quarti-Trevano1,2, Cesare Cuspidi1,3
1Department of Medicine and Surgery, University Milano-Bicocca, Italy (G.G., F.Q.-T., C.C., G.M.).
Hypertension (Dallas, Tex. : 1979)
|June 18, 2025
概括
与非耐药性高血压相比,耐药性高血压 (RHT) 显示出明显更高的交感神经活动. 像心率和北上腺素这样的标准标志物并不反映RHT患者中这种增加的上腺素过量.
科学领域:
- 心血管生理学心血管生理学
- 高血压研究 高血压研究
- 神经科学是一个神经科学.
背景情况:
- 对治疗有反应的基本高血压患者表现出上腺功能过度活跃.
- 同情神经系统在抗药性高血压 (RHT) 中的作用尚不清楚.
- 研究RHT中的同情激活对于理解其独特的病理生理学至关重要.
研究的目的:
- 为了确定RHT是否以同情激活为特征.
- 为了比较RHT与非RHT中的同情激活的大小和机制.
- 评估心率,北上腺素和巴罗反射功能的实用性,作为RHT中的同情活动标志物.
主要方法:
- 对12项研究 (508名患者) 的元分析,研究了RHT中的肌肉交感神经流量 (MSNA).
- 在RHT,非RHT和正常压力个体之间比较MSNA水平.
- 在RHT中评估MSNA,心率,血北上腺素和巴罗反射功能的关系.
主要成果:
- 在RHT患者中,MSNA显著升高,与正常血压和非RHT患者相比.
- 在RHT中MSNA的升高与心率或血北上腺素水平无关.
- 巴罗反射功能与RHT中的MSNA相反相关,类似于非RHT.
结论:
- RHT是由明显和持续的同情性过度驱动来定义的.
- 在RHT中,同情激活明显大于非RHT.
- 心率和北上腺素是RHT中同情活动升高的不可靠指标.
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